De-problematising Aboriginal young peoples' health and well-being through their voice: An Indigenous scoping review.

BACKGROUND: The continued use of a deficit discourse when researching Aboriginal and Torres Strait Islander Peoples of Australia is problematic. Understanding and challenging the researchers position and the power of the words they use is important. It will ensure we do not persist in framing Aboriginal and Torres Strait Islander People as a problem to be solved. DESIGN: Indigenist review of the evidence of Aboriginal young people's health and well-being. METHODS: This review was conducted using an Indigenist approach to identify texts which amplified the voices of Aboriginal young people of Australia and presents a narrative summary of their accounts. This review is reported in line with the PRISMA-ScR reporting guidelines. RESULTS: Culture and connection are critical components of Aboriginal young people's health and well-being. Aboriginal young people describe feeling of powerlessness to influence health and well-being of their community, and they understood the risks they and their communities faced. Young people identified the importance of connection to culture, community and Elders as crucial to their social and emotional well-being. CONCLUSION: By harnessing an Indigenous analysis, we were able to reveal a strong counter narrative of strength and resilience within their historical, social, and political contexts through the storied accounts of Aboriginal young people. RELEVANCE TO CLINICAL PRACTICE: Most of the currently available evidence about Aboriginal health and well-being is immersed in deficit discourse. Literature reviews being the foundation of research and informing nursing practice, we call for a purposeful shift towards the adoption of an Indigenist strength-based approach which emphasises the strength and resilience of Aboriginal young people.

Mixed Methods Study Integration: Nursing student experiences and opinions of intentional rounding.

AIMS: To explore pre-registration nursing students' understandings and experience of intentional rounding in education and clinical sectors. Intentional rounding is a patient safety intervention used in clinical settings to regularly check and document patients' welfare and environment throughout the course of a shift. DESIGN: An explanatory sequential mixed methods design using convenience sampling was used for this study, with an underlying pragmatic paradigm. Integration occurred in the design, methods, implementation and reporting phases of the study. METHODS: Data were collected between August 2017 and August 2018 using a previously validated Nursing Perceptions of Patient Rounding quantitative online survey followed by individual qualitative interviews using the same cohort. RESULTS: Using the Pillar Integration Process, this paper displays and discusses the final results. The integration and mixing throughout the study generated insights into the perceived benefits of intentional rounding for nursing students and patients but also indicated a theory-practice gap that affects nursing students' confidence in undertaking this intervention. CONCLUSION: Students find this patient safety intervention helpful, but further clarity in the education surrounding it is required. IMPACT: This study addresses pre-registration nursing students' understanding and perceptions of intentional rounding. Intentional rounding benefits nursing students as a patient safety strategy and organization tool. Educational opportunities around the topic could be enhanced, reducing the ongoing theory-practice gap. Clinicians, academics and educators who support pre-registration nursing students in clinical and tertiary education settings can benefit from this work.

Australian medical students' and junior doctors' perceptions of gender discrepancies in obstetrics and gynaecology.

BACKGROUND: There is currently a gender imbalance 85:15 female/male in the intake into specialist training for the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG). AIMS: To determine the views and perceptions of Australian medical students, and junior doctors in the first five years of practice, toward obstetrics and gynaecology (O&G) as a career, including whether there are any perceived barriers to the pursuit of such a career. MATERIALS AND METHODS: A semi-structured questionnaire was developed with members of the RANZCOG Gender Equity and Diversity Working Group There were two separate studies: the first involved telephone interviews of medical students across three campuses of a medical school in North Queensland. The second study surveyed junior doctors in Queensland who are members of the Australian Medical Association. Responses were analysed and compared using quantitative and qualitative methods. RESULTS: Both studies found that experiences with O&G as a medical student influenced the decision to pursue O&G as a career. Exclusion from clinical scenarios and difficulty establishing good relationship with midwives within busy birthing suites were some reasons deterring male students from O&G. In addition, students felt poorly informed about the specialty in their preclinical years, affecting their early decisions in choice of specialty. Post-rotation, more female than male students reported positive experiences and were considering O&G as a career. CONCLUSIONS: Both groups see medical student experience as critical in attitudes toward the specialty as a possible career. This experience plays a significant role in encouraging female students toward a career in O&G and discouraging male students. More exposure to the specialty in the preclinical years, and attention to improving clinical rotations for all students, is required.

"Complexity, safety and challenges: Emergency responders' experience of people affected by methamphetamines".

Providing care to methamphetamine-related callout events in the prehospital environment is often complex and resource-intensive, requiring staff to manage agitation and violence-related side effects of methamphetamines. In Australia, emergency responders are increasingly required to attend events related to methamphetamines, even though reports suggest methamphetamine use across Australia has declined. The aim of the study was to explore Australian police and paramedic experiences attending methamphetamine-related events. A qualitative descriptive phenomenology design was employed using semi-structured interviews with employed police (10) and paramedics (8) from Australia. Data were analyzed using thematic analysis. Participants described the complexities associated with providing prehospital care to people affected by methamphetamines. Participants described associated domestic/family violence, increased levels of violence, challenges with communication, and responder emotional and psychological distress and physical injury. Violence associated with methamphetamine use is a critical factor in prehospital care. Workplace violence and family/domestic violence are important issues that require further research to ensure families and staff are well supported and have the services they need to continue responding to people affected by methamphetamine use.

Induced abortion in Papua-New Guinea: Experience and opinions of health professionals.

BACKGROUND: Papua-New Guinea (PNG) has one of the highest maternal mortality rates in the world; complications due to unsafe abortion are an important cause. Abortion laws are restrictive, and safe, induced abortions are unavailable to the majority of women, while unsafe abortions are known to be practised throughout the country. The topic of abortion is stigmatised, for women and health professionals. AIM: To conduct a study of PNG health professionals' experience of induced abortion and their views on the provision of safe, accessible abortion services for PNG women. MATERIALS AND METHODS: A questionnaire developed from similar surveys conducted in Australia and New Zealand was distributed in 2017 to doctors working in provincial hospitals of the public health system; in 2020, the questionnaire was distributed to doctors and nursing staff in Port Moresby General Hospital, and to medical, nursing and health sciences students in the University of Papua-New Guinea. RESULTS: Significant numbers of senior medical officers and nurses reported experience of women presenting following unsafe induced abortion. There was wide variation across all respondents with regard to accurate knowledge of PNG's abortion laws, and to views on the provision of safe accessible abortion services in the country's public health system. CONCLUSIONS: Abortion training for service providers and provision of primary care services are necessary to ensure that PNG women have equitable access to abortion care instead of seeking out untrained providers or attempting self-abortion. Innovative approaches also need to be adopted to complement family planning efforts in PNG.

Clinical experience of trainees of The Royal Australian and New Zealand College of Obstetricians and Gynaecologists in insertion of long-acting reversible contraceptives.

BACKGROUND: Long-acting reversible contraceptives (LARCs) include both progestogen-containing implants and intrauterine devices releasing either a progestogen or copper, providing highly effective contraception. Increasing uptake of LARCs is advocated by governments and professional organisations as an important strategy to reduce unintended pregnancy; such uptake requires, among other measures, adequate training of doctors in the areas of obstetrics and gynaecology and women's health. AIMS: To assess The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) trainees' (Fellowship, Diploma or Certificate of Women's Health) experience and training in insertion and removal of LARCs. MATERIALS AND METHODS: An invitation email to participate in an anonymous survey approved by the Continuing Professional Development Committee of RANZCOG was sent to all current RANZCOG trainees in the three categories. The responses were categorised and analysed. RESULTS: Of 1686 invited trainees, 294 (17.4%) responded: 250 in Australia and 44 in New Zealand; 127 were undertaking Fellowship training (8.3% of those invited) and 166 (100% of those invited) were undertaking training for the Diploma (either DRANZCOG and DRANZCOG Advanced) or the Certificate of Women's Health. Significant numbers of all categories of trainees had no or limited experience of insertion or removal of LARCs of all types and/or lacked self-confidence in LARC provision. CONCLUSION: RANZCOG needs to address this training deficiency to continue as the leader in Australia in the provision of women's reproductive healthcare.

Views and practices of induced abortion among Australian Fellows and trainees of The Royal Australian and New Zealand College of Obstetricians and Gynaecologists: A second study.

OBJECTIVES: Knowledge of current practices of abortion is important for planning of health services in Australia and for future training. AIMS: To conduct an online survey of the Fellows and specialist trainees of RANZCOG regarding their views and practices of induced abortion and compare these with results of a similar study from 2010. METHODS AND MATERIALS: A questionnaire was distributed to Australian Fellows and specialist trainees. Data collected were descriptively analysed and thematic analysis used for free comments. RESULTS: Approximately 25% of those emailed responded (632 of 2542); 13.7% reported total opposition to abortion on religious or conscientious grounds; the remainder did not. 83.5% believed that abortion should be part of general obstetric and gynaecological practice; 90% believed that education about abortion should be part of the curriculum for RANZCOG trainees. 92% supported public hospital provision of abortion services. A range of views was explored using thematic analysis. DISCUSSION: While a majority of Fellows and trainees do not hold religious or conscientious objections to abortion a significant minority do; this has changed little since 2010. Many respondents distinguish between 'medical' and 'social' indications for abortion although definitions of 'social' appear variable. There was strong support for the inclusion of abortion in the Fellowship training curriculum. CONCLUSION: Although the response rate was lower than for the 2010 survey participants expressed strong support for the provision of abortion services in the public sector in Australia, and for incorporation of information about abortion in the training curriculum for Fellowship of RANZCOG.

A prospective review of perinatal mortality at Hospital Nacional Guido Valadares (HNGV).

BACKGROUND: Timor-Leste has one of the highest perinatal mortality rates in the Asia-Pacific region. Consistent and accurate data collection improves understanding of perinatal outcomes and facilitates the development of interventions to reduce stillbirths and early neonatal deaths. AIMS: (1) To identify changes in the rates of stillbirth and early neonatal deaths from previous published data. (2) To determine if prospective data collection and the application of the simplified Causes Of Death and Associated Conditions (CODAC) classification allows better identification of perinatal deaths in Timor-Leste. METHODS: A prospective audit of perinatal deaths of women delivering at Hospital Nacional Guido Valadares (HNGV) was undertaken from January to June 2016 inclusive. The hospital birth registry, maternal and neonatal records were reviewed to determine the most likely aetiology and classification of perinatal deaths using the simplified CODAC system. RESULTS: One hundred and ten stillbirths and 28 early neonatal deaths were identified. Fifty-four percent of perinatal deaths occurred antepartum, 26% intrapartum and 20% were early neonatal deaths. Cause of death among stillbirths could not be ascertained in 40% of cases. Intrapartum asphyxia was the commonest identified aetiology of intrapartum and early neonatal deaths. CONCLUSION: There has been limited improvement in the rate of stillbirths and early neonatal deaths at HNGV. Intrapartum hypoxia and maternal hypertensive conditions were the most common identified aetiologies highlighting areas where targeted interventions may help reduce high perinatal mortality rates. Aetiology of perinatal deaths, particularly antepartum stillbirths was difficult to discern even when well-tested classification systems are used.

Nurse and patient satisfaction with intentional rounding in a rural Australian setting.

AIMS AND OBJECTIVES: To compare nurse and patient satisfaction with intentional rounding in a rural Australian hospital setting and examine which aspects of care predict satisfaction. BACKGROUND: Intentional rounding is a systematic process used by healthcare professionals to anticipate and address the fundamental needs of hospitalised patients. Despite a wealth of literature about nurse and patient satisfaction with intentional rounding, no studies have compared nurse and patient satisfaction, and little is known about intentional rounding in a rural setting. DESIGN: A cross-sectional study was undertaken with nursing staff and patients at a rural hospital and reported in accordance with STROBE guidelines. METHODS: Nurses (n = 63) and patients (n = 66) were invited to complete the Patient Satisfaction Survey between April and June 2018. Nurse and patient responses were compared and predictors of nurse and patient satisfaction with intentional rounding care were determined using generalised estimating equation models. RESULTS: Both nurses and patients positively rated satisfaction with all aspects of nursing care provided and received through intentional rounding. Nurses' satisfaction with care provided to patients through intentional rounding was predicted by interest in patients' feelings about their care. Patient satisfaction with the care they received whilst hospitalised was predicted by the ability to see a nurse when they needed to, the provision of pain relief when needed, feeling comfortable and safe, and the perception that nurses were interested in their feelings about their care. CONCLUSION: Intentional rounding is a means for nurses to regularly attend to patients' emotional and physical needs, which is central to patients feeling safe and cared for whilst hospitalised. RELEVANCE TO CLINICAL PRACTICE: Intentional rounding practices ensure that patients feel genuinely cared for by nursing staff whilst hospitalised and can improve nurse and patient interactions, satisfaction and outcomes.

Intentional rounding - An integrative literature review.

AIMS: To establish current knowledge about the efficacy and acceptance of intentional rounding in current practice, from the perspective of nurses, patients, patient satisfaction and safety indicators. BACKGROUND: Intentional rounding is a formal means of nursing staff checking care needs of patients in hospital settings on a regular basis. DESIGN: An integrative literature review conducted following the Joanna Briggs Institute manual. DATA SOURCES: A literature search from 2000 - 2017 was conducted using the following electronic databases: The Cumulative Index to Nursing and Allied Health Literature, ProQuest, PubMed, Informit, Sage and Scopus. REVIEW METHODS: Articles were assessed for quality and rigor using the Critical Appraisal Skills Program tool and the Effective Public Health Practice Project Quality Assessment tool for Quantitative Studies. A sequential explanatory mixed studies approach was used to combine qualitative and quantitative evidence in a single review. In-depth parallel reviews of the quantitative and qualitative evidence were undertaken, and then a synthesis of the combined qualitative and quantitative evidence conducted. RESULTS: Intentional rounding has positive outcomes on patient satisfaction and safety. Nurses perceive benefits related to intentional rounding; however, some nurses perceive it as an additional, unnecessary task. The effectiveness of intentional rounding is influenced by external factors including leadership and formal rounding education, workload, ward layout, staffing and experience level. CONCLUSION: Intentional rounding is a positive intervention in patient safety and satisfaction generally, but needs further research and consideration about actual impact, staff delegation, education and engagement, student nurse involvement, documentation and specializing the structure of intentional rounding.

A clinical audit of combined first trimester screening and non-invasive prenatal testing offered to pregnant women in a regional Australian hospital.

The records of women attending a large Australian regional hospital for antenatal care were retrospectively analysed to determine what proportion had undergone or been offered first trimester screening for fetal abnormalities; only 609 (54%) of 1114 women had undergone or been offered screening. Younger women, multiparous women and women living in rural Australia were less likely to be offered screening. Barriers to screening and solutions for overcoming these need to be identified to improve access and equality in antenatal screening for all women.

Natural fertility, infertility and the role of medically assisted reproduction: The knowledge amongst women of reproductive age in North Queensland.

BACKGROUND: The demand for medically assisted reproduction continues to increase, with more women encountering challenges with fertility. Due to misconceptions and gaps in knowledge, women are often unaware of the risks related to delayed childbearing. Lack of understanding of natural fertility, infertility and the role of medically assisted reproduction can lead to emotional suffering and changes in family plans. AIMS: To assess the understanding and knowledge that women of reproductive age in North Queensland have regarding natural fertility, infertility and the role of medically assisted reproduction. MATERIALS AND METHODS: Data were collected from 120 women (30 nurses, 30 teachers, 30 university students and 30 Technical and Further Education students) via the distribution of a structured questionnaire. Participants were surveyed in person about their personal plans and opinions, knowledge about natural fertility, infertility and medically assisted reproduction, and their preferred source of information. RESULTS: Participants demonstrated suboptimal knowledge levels throughout all sections of the questionnaire, in particular when asked about medically assisted reproduction. When asked to identify their main source of information, 'friends and family' was the most popular choice. CONCLUSIONS: Results from this North Queensland study add to the existing international literature, highlighting the widespread nature of the problem. Without adequate understanding of natural fertility, the risks of infertility, and the role and limitations of medically assisted reproduction, women make uninformed decisions. Development of local reproductive health education programs need to be instigated in response.

Maternal mortality and 'near miss' morbidity at a tertiary hospital in Timor-Leste.

BACKGROUND: Assessment of severe maternal morbidity is increasingly being undertaken to understand the aetiology and factors which lead to adverse maternal outcomes. Their use in conjunction with maternal deaths may allow a comprehensive assessment of care provided, highlight areas for improvement within the health system and allow benchmarking of care against other institutions. Timor-Leste has one of the highest rates of maternal mortality in the Asia-Pacific region; however, there has been limited research into the level of severe obstetric morbidity in the country. AIM: To determine the aetiology and rates of severe obstetric morbidity and mortality at Hospital Nacional Guido Valadares, Timor-Leste. METHODS AND MATERIALS: Cases of maternal 'near misses' and deaths were prospectively identified over a period of 12 months using the World Health Organization maternal near-miss criteria. Cases of maternal death and near miss were combined (severe maternal outcomes) for descriptive analysis. RESULTS: During the audit period, 69 severe maternal outcomes were identified: 30 maternal deaths and 39 'near misses'. The maternal mortality ratio and the maternal near-miss ratio were 662/100 000 live births and 8/1000 live births, respectively. The main identified obstetric aetiologies were haemorrhage and pre-eclampsia, while 22% of severe maternal outcomes did not have a clearly identified cause. CONCLUSION: The high institutional maternal mortality ratio requires urgent attention and identification of areas for improvement. Auditing and benchmarking using the WHO near-miss criteria provide a mechanism for standardised comparison of obstetric care but require further refinement to the local context.

Nurse-led postdischarge telephone follow-up calls: A mixed study systematic review.

AIMS AND OBJECTIVES: To explore the quantitative and qualitative literature on the impact of nurse-led postdischarge telephone follow-up (TFU) call interventions on patient outcomes. BACKGROUND: Adverse patient outcomes such as postdischarge problems, premature contact with health systems, inability to self-manage conditions and hospital readmissions all have an impact on the health and well-being, and satisfaction of patients as well as a financial impact on healthcare systems. DESIGN: A mixed-study systematic review. REVIEW METHODS: A systematic search of CINAHL, Ebsco, PubMed, Quest and Cinch-Health databases was undertaken using the key terms "nurs*," "nurse-led," "nurse initiated," "discharge," "hospital," "telephone," "follow-up" and "telephone follow-up" to identify relevant original peer-reviewed studies published between 2010-2016. Ten articles were selected for inclusion. The selected papers were critically appraised. A sequential explanatory approach with a convergent synthesis was used to report findings following PRISMA guidelines. RESULTS: The findings demonstrate that nurse-led TFU interventions have the potential to improve patient outcomes. The studies suggest patient satisfaction with TFU is one of the strongest positive outcomes from the interventions. However, the results do not support improvement in patient readmission or mortality. CONCLUSIONS: Of the 10 studies reviewed, only two were methodologically strong limiting the conclusions that can be drawn from the current research on this topic. Telephone follow-up interventions improve patient satisfaction and have the potential to meet patient information and communication needs, improve self-management and follow-up appointment attendance and reduce postdischarge problems. Further research is required to explore patients' perceptions of the most useful content of TFU calls, the efficacy of TFU calls and nurses' perceptions and experiences of conducting TFU interventions. RELEVANCE TO CLINICAL PRACTICE: When conducted by a nurse, these interventions have the potential to enhance postdischarge care to patients and meet care needs. Patients perceive TFU as acceptable and are satisfied with this form of postdischarge care.

Bronchiectasis in indigenous and non-indigenous residents of Australia and New Zealand.

BACKGROUND AND OBJECTIVE: Bronchiectasis not associated with cystic fibrosis is an increasingly recognized chronic lung disease. In Oceania, indigenous populations experience a disproportionately high burden of disease. We aimed to describe the natural history of bronchiectasis and identify risk factors associated with premature mortality within a cohort of Aboriginal Australians, New Zealand Maori and Pacific Islanders, and non-indigenous Australians and New Zealanders. METHODS: This was a retrospective cohort study of bronchiectasis patients aged >15 years at three hospitals: Alice Springs Hospital and Monash Medical Centre in Australia, and Middlemore Hospital in New Zealand. Data included demographics, ethnicity, sputum microbiology, radiology, spirometry, hospitalization and survival over 5 years of follow-up. RESULTS: Aboriginal Australians were significantly younger and died at a significantly younger age than other groups. Age- and sex-adjusted all-cause mortality was higher for Aboriginal Australians (hazard ratio (HR): 3.9), and respiratory-related mortality was higher for both Aboriginal Australians (HR: 4.3) and Maori and Pacific Islander people (HR: 1.7). Hospitalization was common: Aboriginal Australians had 2.9 admissions/person-year and 16.9 days in hospital/person-year. Despite Aboriginal Australians having poorer prognosis, calculation of the FACED score suggested milder disease in this group. Sputum microbiology varied with Aspergillus fumigatus more often isolated from non-indigenous patients. Airflow obstruction was common (66.9%) but not invariable. CONCLUSIONS: Bronchiectasis is not one disease. It has a significant impact on healthcare utilization and survival. Differences between populations are likely to relate to differing aetiologies and understanding the drivers of bronchiectasis in disadvantaged populations will be key.

The impact of patient safety culture on handover in rural health facilities.

BACKGROUND: Effective handover is crucial for patient safety. Rural health care organisations have particular challenges in relation to handover of information, placing them at higher risk of adverse events. Few studies have examined the relationship between handover and patient safety in rural contexts, particularly in Australia. This study aimed to explore the effect of handover on overall perceptions of patient safety and the effect of other patient safety dimensions on handover in a rural Australian setting. METHODS: A cross-sectional online survey using The Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture was implemented across six rural Local Health Districts in NSW, Australia and resulted in 1587 respondents. Hierarchical multiple linear regression analysis was conducted to account for the nested nature of the data. Models were developed to assess the effect of handover on patient safety perceptions, and the effect of other patient safety culture composites on handover variables. Open-ended questions about patient safety were inductively analyzed for themes. Quotes from the handover theme are presented. RESULTS: All models were significant overall (p < .001), with explanatory powers ranging from 29 to 48%. Within rural health settings, effective handover is significantly related to patient safety perceptions (R2 = .29). A strong teamwork culture and management support culture was found to enhance effective handover of patient information (R2 = .47), and effective handover of personal responsibility (R2 = .37). A strong teamwork, management support, and open communication culture enhances handover of department accountability (R2 = .41). Despite the implementation of standardised communication tools and frameworks for handover, patient safety is compromised by inadequate coordination, poor or absent documentation between departments, between other health care agencies and in transfer of care from acute facilities to primary/community care. CONCLUSION: Approaches to handover need to consider the particular challenges associated with rurality and strengthening elements found to be associated with increased safety, such as a strong teamwork and management culture and good reporting practices. Research is required to examine how communication at transition of care, particularly between facilities, is conducted and ways in which to enhance patients' and families' participation.

Medical students and midwives - How do they view each other?

Medical students from James Cook University who had completed their rotation in obstetrics, and midwives working in Cairns Hospital who had undertaken supervision of medical students in the birth suite, were invited to complete anonymous questionnaires on their views of their respective roles in the birth suite. Several issues were identified including increased medical and midwifery student numbers, and lack of communication between midwives and medical students. Increased cooperation and communication between medical and midwifery education providers is urgently needed to improve both student groups' learning experiences.

Maternal-choice caesarean section versus planned vaginal birth in low-risk primigravid women.

Rising rates of caesarean section (CS) have been attributed, in part, to maternal-choice CS (MCCS). There are few published data regarding maternal and perinatal risks comparing MCCS with planned vaginal birth (VB) in uncomplicated first pregnancies to inform choice. We report the results of a pragmatic patient-preference cohort study of private patients in Australia: 64 women planning MCCS and 113 women planning VB. There were few differences in outcome between the two groups. The study highlighted the well-recognised difficulties in undertaking prospective research into MCCS.

A randomised controlled trial of consumption of dark chocolate in pregnancy to reduce pre-eclampsia: Difficulties in recruitment, allocation and adherence.

In 2013-2014 we undertook a randomised controlled trial (RCT) to determine whether the daily ingestion of dark chocolate during pregnancy could reduce the incidence of pre-eclampsia in primigravidae. However, after two years we had not succeeded in recruiting more than 3.5% of the number of participants required to answer the research question, and the trial was halted. We also reviewed the literature on this topic and found it to be limited. We report here our findings and discuss the difficulties facing researchers in this area.

Rates and features of methamphetamine-related presentations to emergency departments: An integrative literature review.

AIMS AND OBJECTIVES: To review the clinical impact methamphetamine has on emergency departments by assessing the available research on the rates and features of methamphetamine-related presentations. BACKGROUND: Globally, methamphetamine availability, distribution and use have rapidly increased. As a result, the number of methamphetamine-related presentations to emergency departments has also increased. In this context, it is timely to review the rate and features of methamphetamine-related presentations to understand the impact of methamphetamine on emergency departments and facilitate the allocation of services, staff and resources. DESIGN: An integrative literature review. METHODS: This study presents an integrated literature review, following the systematic review process as outlined in the PRISMA flow chart. Several databases were searched using a combination of search terms. Articles were measured against inclusion and exclusion criteria, and the final ten articles were subjected to quality appraisal and outcomes reported. RESULTS: Methamphetamine accounted for 2.3% or less of all emergency departments presentations. The majority of methamphetamine users presenting to emergency departments were males, with a mean age 31-37. Methamphetamine-related presentations to emergency departments were more likely to present with trauma, psychosis, and be placed on 24-hr psychiatric hold. Methamphetamine-related presentations were more likely to present with agitation, aggression and homicidal behaviour and present to emergency departments out of hours and accompanied by police compared with other emergency departments substance-related presentations. CONCLUSIONS: Several important themes were highlighted in this review that has an impact on emergency departments services, resources and staff. Understanding the rate and patterns of methamphetamine-related presentations can help to provide evidence for policy development and staff education in emergency departments. RELEVANCE TO CLINICAL PRACTICE: Methamphetamine-related presenters are more aggressive and agitated and more likely to be brought in by police. There is a need for policy development and staff training around these issues and further research in this area using stronger study designs.